| NPI | 1093992810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE IHIOMA ONYEKABA Director 763-566-4535 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MN 36657) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2008-01-23 |